Author: Ethical Vet

In October I travelled from the UK to the Nirina dog shelter in Tuzla, Bosnia and Herzegovina. The shelter houses over 500 stray dogs. I drove the 2700 mile trip in my Transit van, taking donated food, equipment and medicines and spent some time discovering how Nirina operates.

Nirina

Why Nirina?

So why not help a British shelter? Firstly, I wanted to experience genuine street dogs, as opposed to abandoned, pre-owned animals. I’ve already worked professionally in 5 different shelters in the UK. Secondly, I don’t agree with the ideals of every organisation in the UK. There is no licensing for dog shelters and rescues, and no qualifications are required to set one up. There is an argument that some approaches to rehoming encourage irresponsible ownership or even indirectly support puppy farming. Thirdly, I’ve found some dog rehoming organisations can be a bit negative or dismissive about veterinarians. I’ve been accused of trying to poach another vet’s work by volunteering. I’ve been told I can’t walk a dog without the necessary training. I’ve adopted a dog and had to sign a form saying I will tell my vet that sighthounds are allergic to anaesthetic (they aren’t!) or that they suffer from SRM and GDV (we know!). But, vets are at fault too- we are not anywhere near where we ought to be at promoting evidence based welfare science or a good understanding of canine behavioural medicine.

Anyway, I heard about Nirina from a colleague on the University of Winchester MSc course in Animal Welfare Science, Ethics and Law, and started following them on Facebook. I was impressed with the sheer scale of their enterprise, the conditions they work under, but most of all the honesty with which they operate. I knew that my colleague would not be supporting them without a full investigation of their ethics and legitimacy, but what I really liked is that they don’t dress up the reality of caring for so many homeless dogs in difficult conditions with false sentiment, just to attract donations. I passionately believe that true change in attitudes to dog welfare can only come if people are able to see how it really is, not front-of-house versions. I contacted Emina Dimkovic, one of the management leads, and decided to take a trip out there. I raised some money via justgiving and asked my veterinary colleagues for donations of out of date drugs and anything else that might be useful. It was quite the logistical task getting it all together from places like Colwyn Bay, Bradford, Hull, Swansea and the West Country. But thanks to a lot of generosity and help it got to me by one means or another and I loaded it up. The various bits of regulatory paperwork were covered, the Eurotunnel and insurance booked, and I was off. I did have a spot of bother getting my van into Bosnia and had to leave it in Croatia (just as well as apparently if i’d slept in it at the shelter the rats would have eaten the cables)! If a 2700 mile drive across Europe in a rattly old van sounds like a stressful experience, I can promise you it was nowhere near as difficult as being polite to a bulldog owner who has just told me the sound of their pet choking on its own anatomy is “how its supposed to be”.

Some of the donations during inventory

The shelter

At the time of my visit, the shelter housed 541 dogs. It’s hard to comprehend just how many this is- and there are only 4 members of full time salaried staff to look after them. No British shelter would comprehend this kind of ratio. The dogs live in groups, in large runs with wooden kennels. The groups consist of 2 to 20, with an average of perhaps 6 or 8. The composition of the groups tends to happen organically- some come in from the streets as an existing pack, or are siblings. All are neutered. There is no electricity or running water here. Power, if needed, comes from a petrol generator, and water is stored in tanks on site which the city council fills, snow permitting.

Just a few of the 500+ dogs

Fighting between dogs is one of the biggest issues here. They all have their basic needs of food, water and shelter met, and they have a level of social interaction with other dogs that most British dogs might envy if they were able, but any tensions are heightened due to lack of space. Changes in the weather are reported to increase aggression, and fireworks or other stressors can cause a contagion of nervousness amongst the dogs. Emina thinks that the optimum number would be about 400. There was no way of doing anything resembling a scientific study in the time available but it seems likely that some of the dogs may experience boredom and frustration due to confinement. The larger spaces they have to play and run in are only available every second or third day on an alternating rota. Volunteers walk the dogs but the numbers are far to great to be able to walk all of them daily, or even weekly. About 50 are not handleable by humans at all.

Despite these issues, the majority of the time the dogs are relaxed and happy. If they need one thing it’s more individual attention. Most are well socialised to humans and run to greet you as you enter their space. They play with each other and with any environmental enrichment offered, but not dog toys- few dogs here know what to do with a toy. Most have never been owned by or played with a human being. It pains me greatly to think what great pleasure these dogs could bring to humans somewhere if only they had the chance, while elsewhere unlimited breeding and shameless marketing of diseased puppies causes a huge welfare crisis.

Some of the canine residents comprise the ‘kitchen gang’- they roam around the parking area and staff room, and can go in and out of the gate as they wish. Most of these have never left the shelter, even though they could. They would never survive on the street, but couldn’t cope with adoption either. One old timer (about 15 years), pictured below, was born here and has never been touched by a human being. By the time the neutering programme began he was already elderly and has no access to entire females. By any subjective measure he appears to have a great life of complete freedom, human interaction on his own terms, unlimited canine socialisation, and no competition for plentiful food. Many dogs in the UK live in complete isolation from their own species, home alone for 8 or more hours a day, insufficiently exercised and fed to obesity. None of these ex-street dogs have a behavioural pathology directly induced by human companionship.

One of the elderly ‘kitchen gang’

What is most notable, and beautiful, to a British vet is the complete absence of extreme anatomy. Most of the dogs are hybrid street dogs, many are medium sized, medium coated and medium brown! There are some with characteristics of the type used for hunting here, and the occasional blue eye speaks of the fashion for Huskies which has reached Bosnia – with consequent abandonment as owners realise the breed does not adapt well to a sedentary life in an apartment. There are no choking brachycephalics with corneal ulcers, no miniatures with crowded teeth rotting out of their heads, no giants with developmental orthopaedic disease, and no chondrodystrophic breeds with the attendant spinal paralysis. No dogs need special diets for food allergy, and no one has atopy. This is what dogs are like when they’re not a fashion item- by and large a very healthy population, with the exception of infectious diseases and traumatic incidents (most of which wouldn’t be an issue if more people adopted them and numbers decreased). It’s hard not to look around Nirina and wonder why someone would choose to spend £3000 on a bulldog, and thousands more surgically enabling it to do the basics like breathe, and see. Wow.. what that money could do here… and why wouldn’t you want a healthy dog anyway?

More than this, there’s a noticeable absence of the kind of behavioural pathology we are used to seeing in the UK. Most of the dogs are well socialised to other dogs. The fighting issues are probably normal for the environment they’re in rather than pathological per se. Separation anxiety is not an issue, and the dogs nervous of humans are left alone, not pressured. Dog bites to humans are very uncommon here. I walked into almost every pen and got jumped on by dogs but never felt like I would be bitten. The risk factors for dog bites in Britain mostly don’t exist here.

Puppies are sometimes dumped at Nirina, by owners of bitches who have bred by accident- neutering is unpopular here for owned dogs. But they can rarely survive the challenge to their immune systems- the chances they come from a vaccinated dam are slim, and being exposed to pathogens from 500+ dogs, even vaccinated ones, is too much. A genuine isolation facility is just not feasible. The barely-weaned pups pictured below were left at the gate just a few minutes after I arrived. They were wormed and set up with some food, water and shelter nearby in what was effectively a fly tipping area. It may look rough, but this was exactly the right thing to do for them. They may not come with 4 weeks free insurance and an invitation to the local puppy party, but if they survive they will be well socialised and have a great life.

Abandoned puppies

Winters are tough at the shelter. Emina describes a feeling that the year is either spent preparing for winter, or surviving winter. The temperature is consistently -10 to -25 degrees and the daylight hours are short. Some days it can take all of that to thaw out the water tanks and break the ice on the dogs’ water supply. They cook meat soups for the dogs to warm them up, and they sleep in straw beds protected from the elements, but it is still very cold. It’s fair to say that my thin-skinned lurchers wouldn’t like it. I had to laugh out loud when I got the answer to my question “what do you do with all that dog poo?” – chuck it in the hedgerows! Don’t try this at home- it would certainly get the Daily Mail readers going 😀

All the dogs admitted to Nirina are neutered, and have a primary course of core vaccines, including rabies. The municipality pay for rabies vaccine and neutering but otherwise give no funds. The Nirina team experimented with the municipal contract but were forced to have more dogs than is humane- at one time more than 700. They took the brave decision to ditch this and continue on donations from international friends- and this seems to be working well. The shelter volunteers also feed street dogs around Tuzla, which are caught and neutered/tagged in a separate project.

The dogs don’t receive booster vaccines- this would be very costly, and a huge logistical challenge, for which the risk/benefit ratio lands in favour of not doing it. This is a virtually closed community, and the balance of herd and individual medicine is fascinating- something we just don’t see in the UK. When something wrong is spotted at Nirina, it is treated- be it an eye infection or a skin tumour in need of removing, but the idea of individual health checks, geriatric blood profiles or “he just doesn’t seem himself” is laughable. Even in a typical British rehoming kennels, it’s likely that each dog has someone to keep an eye on everything it does, from food intake to urine colour. To do this at Nirina would mean consigning literally hundreds of dogs to street life, with all that entails- danger from traffic, hostility from humans, insecure food supply and vulnerability to disease. If you want things to be different, don’t breed, and adopt don’t shop! If we solved the massive overpopulation crisis of dogs in Britain, we would be able to help dogs like this much more easily, and ethically.

Healthy, happy, and just waiting for adoption

Speaking of caring for dogs, the world of veterinary practice is very different in Bosnia. There is no compulsory requirement for out-of-hours services- people just accept you cannot get a vet on a night or weekend. You can forget special certificates in Emergency and Critical Care medicine. How I would like to say this to the next person who rings me up at 2am demanding an instant home visit for a relatively trivial condition! The nearest vet to Nirina that even has gaseous anaesthesia is in Sarajevo- that’s a 2.5 hour drive. Imagine this- no British vet will ever have not experienced a client complaining about the cost of a dental, but then imagine saying to the complainant that you can do it cheaper without gas- just don’t sue me when your dog gets a lump of dental calculus in its airway and needs a lung lobectomy. It’s a different world. When our clients complain about the cost of veterinary care they rarely have a notion of how fortunate they are to have access to the skill base and technology that exists in Britain. If only they didn’t add insult to injury by buying a dog with all manner of predictable, preventable, and expensive medical issues I would be a very happy woman. But I’m not holding my breath.

Background

The attitude to Bosnian street dogs from residents is generally hostile or disinterested. They may be ignored, or have rocks thrown at them, but generally regarded as a nuisance. A British dog can rarely get 10 yards down the road on its own before a passer by has scooped it up. Although it is illegal to kill Bosnian street dogs, some people will circumvent this by making use of a livestock protection clause in the law, even if the dogs were nowhere near any. The street dog population is seen as conceptually different from pet dogs, which may be pampered as much as in the UK. Generally though, it is culturally and economically less common to keep dogs as pets, rather than for work.

Just another dog that needs help from the human race

Prior to the current team taking over, the shelter in Tuzla was a pretty grim place by all accounts. The then manager took the city contract for financial gain, and this entails an intake of around 250 dogs per month, with no realistic means to care for them. Population control consisted of stronger dogs killing weaker ones. They were fed on chicken beaks and claws- the pups couldn’t eat this at all, so they starved. The ones that could had to eat so fast that they frequently got penetrating oesophageal or other gastrointestinal foreign bodies- no treatment was given and they died what must be a very unpleasant death. When Emina, Andrijana and team took over 5 years ago, improvements were rapid, welfare-driven and pragmatic. The shelter became Nirina, which means ‘wanted’.

Rehoming

In the 5 years since Nirina began, about 900 street dogs have been re-homed. Almost all go abroad- Austria, Germany, Slovenia, Denmark, a few to the UK. Some of these countries may not even have dog shelters, or the adopter may not want or be allowed a shelter dog in their own country. There are, of course, ethical issues involved in adopting abroad to a country where homeless dogs already exist- and possibly an unfair perception that owned/relinquished dogs suffer from problematic behavioural issues. And it is probably fair to say that a dog from Nirina is far less likely to have long term behaviour problems than a British ‘rescue’ dog, for example. What is questionable is the assumption that dogs in rehoming centres in Britain have an increased rate of behavioural disturbance compared to the canine population as a whole in the country. For me, the most important point is that when humans understand canine needs better we won’t have so many messed up dogs- whatever their origin. The Nirina dogs take time to adjust to living in a home, and the team has found that rehoming them in their own country is unrewarding for this reason- the human tolerance for allowing them time to adjust is limited, and when they are returned it is hard to reintegrate them back into their original group.

Just a few of the dogs now in permanent homes

The people

I went to Nirina for the dogs- I wanted them to have to have some help via saving on vets bills through the donated medicines and equipment. I am not a people person, and I didn’t expect to be so affected by the people I met in the short time I had there. When I messed up my van registration papers they came over the border to pick me up, gave me pizza and a bed. Maybe not such unusual hospitality, but dig a little deeper and you see example after example of problem-solving positivity in a country where you cannot take anything for granted. Unemployment is high, a living wage is rare, workers rights minimal, and there is no welfare. The public health system, such as it is, runs off bribes. I was lucky enough to have a long chat with Emina, and the story of her father-in-law’s terminal illness and her own C-section made my blood run cold. Any attempt at improving dog welfare has to be taken in the context of the human situation- these are domesticated animals depending, directly or indirectly, on the human population.

Emina grew up in Germany, as a refugee of the Balkan Wars. Age 12, her family were sent home- only home is now a different country, with a new name. Oh, and someone burned their house down and killed a load of their fellow citizens. You just don’t imagine this happening if you live in, let’s say Nuneaton (which I don’t by the way)! It certainly never crossed my mind that I might get home and find war had broken out- but this is what many Bosnians have grown to be afraid of. Emina worked at dog shelters in Germany and brought home what she learned. She is highly educated as a social worker but became disillusioned with the lack of funds to do anything other than listen to people’s problems. This woman is someone who gets stuff done! They have created, to date, four salaried positions at Nirina- not highly paid by any means (it embarrassed me to work out I earn in 15 minutes as a locum what these guys get in a day) but they have security and the knowledge that if they are really sick they needn’t fear having a day off. Although, on the evidence I saw, they spend their days off at the shelter helping anyway- you might think this is out of a fear of being replaced, but I don’t think so. They clearly adore the dogs, and love Emina too. Emina is able to work full time managing the shelter as a volunteer, thanks to her husband, who kicked unemployment in the face by spending a month on a business plan to convince an Austian company to open in Bosnia. It worked, and now he manages a staff of 150. The lucky dogs get the indirect benefit of this enterprising spirit.

I spent more time with Emina, but Andrijana Cajic is an equal part of the management team, currently spending less time at the shelter itself than Emina. Andrijana is another hugely impressive lady- she has a first class law degree, but couldn’t find a job in Bosnia for 11 years because her family were not part of the ‘correct’ political affiliation before the war. Even now, she doesn’t work in the judicial system. What a tragedy that the country doesn’t feel the benefits of her prodigious talents. However, the dogs do.

Dog time

Both Andrijana and Emina have an impressive grasp of the bigger picture of dog welfare which is unfortunately quite hard to find in the UK. They are clear-sighted about what energy and resources they have and where to direct it to best effect. This pragmatism has to be essential for any dog shelter or rehoming enterprise to be most effective. Here’s an example- a non-destruction policy is attractive to donors, and looks lovely in advertisements in British newspapers. But back on earth, if you have the choice of saving 10 young healthy dogs or one old and sickly one, someone has to make those decisions. Every time someone spends a fortune on importing an arthritic, ancient German Shepherd with heartworm (for example, and no disrespect to the GSD which I admire), they are missing an opportunity to save the lives of many other dogs which are going to be destroyed because there are not the resources for them. I don’t like it, and hell I’d save every last dog if I could, but this is reality. What I admire most of all about these Bosnian ladies is that you’d better believe they are not going to bullshit you about how things really are. And if you don’t like that someone has to consider these options as part of their daily life, if you don’t like that some dogs, not as lucky as those at Nirina have a miserable life, sub-optimal care, or die prematurely, you have the option to do something about it. You can stop breeding your dogs. You can stop promoting breeding by buying from unregulated breeders. If you really must buy a puppy, buy a healthy one, not one with ridiculous anatomy or inherited disease, don’t waste your money on fancy feeding fads. Take your dog for a walk instead of buying it an outfit, and most of all don’t get one at all if you can’t afford to look after it! Every single day of my life someone complains to me that vets fees are too expensive- adopt a dog from Nirina, or one just like it, and you’ll probably never need me.

Scotland is soon to vote on whether to bring back tail docking for working dogs, after just 11 years of it being banned. Unlike in England and Wales, where puppies of certain breeds destined for ‘work’ can be docked, the current ban applies to all dogs. It is a much better piece of legislation than the gutless version in the rest of the UK, where I regularly see docked dogs clearly never intended for anything else but family pets.

The cause of this potential U-turn? New evidence. One study found that 232 tails need to be docked to prevent significant tail injury in later life. Another put the figure at 2 to 18 dockings per preventable injury. The largest study to date rates it at 500. So far, so inconsistent.

So what number of tail dockings is acceptable to prevent ‘significant tail injury’ in later life? Well.. i wonder how many readers have seen a puppy’s tail being docked. I have. I once worked in New Zealand where it was common practice. To the dismay of my then employer, I refused to do it. The breeder’s excuse: “we can’t sell them without docking, but we don’t want to..”. The vet’s excuse: “if we don’t do it someone else will, and they might do a bad job”.

When I saw a human being take a scalpel blade and cut through the skin, bone and delicate nervous tissue of a newborn, I couldn’t help thinking that it’s (a) a very significant and irreparable tail injury in itself, and (b) it’s a bad job whoever does it. It made me ashamed to be a vet. And guess what- it hurts them. We now know that neonates have the same or increased perception of pain as adults, and it isn’t always short-lived. Some suffer permanent neuropathic pain as well as losing their biggest communication signalling device.

We know that spaniels and hunt point retrievers do sustain more tail injuries than pet dogs. They also sustain more ear injuries. When did parliament last vote on chopping off dogs’ ears at birth? If preventing injury, not fashion, is the rationale- then they should be. Or what about amputating a limb in case they break it in later life? This argument is rationally and logically absurd.

If the pursuit of ‘country sports’ is so hard on these dogs, if these tail injuries are so severe that we must remove this important part of canine anatomy to prevent them, then maybe there’s another solution. How important is it really to the human race that we need to mutilate one species in order to facilitate the maiming and killing of another? Would the suffering of those who enjoy shooting animals (maybe cleanly, maybe not) be unbearable if they couldn’t do it? Or even if they could do it but without a dog to do the leg work? Would their lives be no longer tolerable if they shot clay pigeons instead? I don’t like guns, so it’s no good asking me…. you decide.

I have a bunch of dogs, and most of them had an imperfect, or downright awful, start in life. I constantly work to give them a good life now. I won’t pretend that any of them are what’s commonly called “well behaved”. Several have atrocious recall, and not a single one of them would pass a Kennel Club ‘Good Citizen’ exam.

This evening I was walking three of my dogs down a country lane. In a field at the roadside were two large mastiffs, loose. Knowing that mine are often dog-reactive, I put in place the counter-conditioning routine that I’ve spent hours, days, weeks and months working on. It doesn’t always work, but it was working today. Just as I was about to reward them for calmly walking past, one of the mastiffs burst through a gap in the fence and attacked my 14kg terrier (see below), dragging him across the tarmac. I tried to hold onto the leads as my strongest dog piled onto the mastiff. The mastiff’s owner dragged it off and commenced to beat it with a whip.

That’s right- he beat it with a whip. As he was doing so, the second mastiff found its way out of the field and attacked the same, smallest, dog I had with me. Luckily I’m a vet, educated in dog behaviour and physically fit, not an old or infirm person strolling along with a teacup chihuahua on a lead or a toddler under my feet.

I see some horrendous dog attack injuries in my job. Fortunately, no blood was even shed on this occasion. I have no issues with the Bull Mastiff as a breed- in fact, I quite like them. But those chunky faces and thick necks are like that because they’re made of solid muscle. These dogs have the physical capacity to kill an adult human, never mind a small dog. However, most of the ones I’ve met have been gentle and docile. It’s like a car parked in the garage- potentially harmful, but only when driven by a moron.

In what world do people think dog aggression is treatable with physical violence? This world, sadly. You don’t see many people carrying a riding whip in public to ‘train’ their dog, but the belief that punishment is an effective solution is widespread. I asked this man why he was whipping his dog, and his reply was: “He has to know he has done wrong”.

Here’s the thing: dogs don’t know the difference between right and wrong. It’s a human construct. They don’t have a moral compass, they don’t have ethics, and they don’t go away and reflect on things. They have behaviour, and they have an ability to learn. And they won’t learn not to attack another dog by being whipped for attacking a dog. They’ll learn that meeting other dogs is scary, painful and threatening. Aggression increases when the threat is increased. Reduce the threat and reduce the risk of an attack. You can train your dog to relax when it sees another dog- you really can! And if it’s too damaged to manage this you can still reduce the risk, take measures to keep other dogs safe, and give it a cracking good life. You don’t ever need to punish it for being a dog.

The near universal cause of dog-on-dog aggression is anxiety, caused by poor socialisation, a bit of genetics and a staggeringly poor understanding of canine behaviour on the part of too many dog owners- setting up a vicious (no pun intended) cycle of fear and learned responses. Owners who love their dogs profoundly, but nevertheless do not understand what makes them tick. Almost no one thinks they’re that person until it’s too late, so if you are struggling alone with an aggressive dog, please ask an APBC-qualified behaviourist for help, or buy a book by someone who has taken the trouble to research actual evidence, not fling out some media-friendly soundbites based on a theory they made up yesterday. Learn about your furry best friends and how to help them be happy. Please.

It’s 1.55 am and you’re about to enter your 96th working hour this week as the night vet in a busy emergency clinic. In another seven hours you get to go home and see your own pets and your own bed. You’re hoping your partner will remember your name since they see so little of you. But first you have to remove a bleeding spleen from a German Shepherd Dog, x-ray a cat’s broken pelvis and do a full blood count on an unstable diabetic. Plus, the other nine in-patients need medications, observations, dressing changes, drips flushing and adjusting, feeding, walking and cleaning out. Clinical notes have to be written, owners updated, and paperwork finished.

The telephone rings. It’s not economically viable to have an all-night receptionist, and the nurse is busy preparing the shepherd for surgery, so you pick up the phone yourself…

Vet: Emergency vet here, can I help you?

Caller: What it is… I’m really worried about my puppy Gucci, he’s been throwing up for 3 days and now he’s collapsed and there’s blood pouring from his back end.. I don’t think he’ll make it til morning!

Vet: [suppressing the urge to ask why they’ve left it this long] That doesn’t sound too good, we should have a look at him straight away. How old is Gucci and what breed is he?

Caller: He’s 10 weeks old I think, he’s a Lhasajuggapoodoggle.

Vet: [bewildered by the latest designer dog name] And has he had his vaccinations?

Caller: They said he had, yeah.

Vet: [sighing internally because you know what’s coming] Were you given a vaccination certificate when you bought him?

Caller: No but they said he’d had everything he’d need..

Vet: I’m concerned he may not be vaccinated if the breeder didn’t provide documents. Do you know if Gucci’s mum was vaccinated? Did she seem healthy?

Caller: I dunno, I met them at the motorway services..

Vet: [repeating for the benefit of the nurse within earshot] The motorway services…?!

You glance up at the nurse in quiet despair. She smiles grimly and points to the digital display on the multi-parameter monitor, drawing your attention to the fact that the shepherd’s blood pressure is falling despite blood replacement products. You need to end the call soon and go to theatre.

Vet: Ok, well make your way down to the clinic in Blogsville: the postcode for your sat nav is BLO6 1ME. Before you travel I’m obliged to let you know that the emergency consult fee is £133.80. We can give you an estimate for Gucci’s treatment when we’ve examined him.

Caller: [incredulous] How much? I don’t have that kind of money!

Vet: [wondering how much a Lhasajuggapoodoggle costs] Do you have any pet insurance for Gucci?

Caller: No. I might get some money next month though.

Vet: Unfortunately we are not allowed to offer credit, you are of course free to obtain it from the usual sources, just as you would for any other unexpected bill.

Caller: I can’t do that, are you telling me I have to just let him die..?

Vet: Not at all. We would never refuse to see a suffering animal. But unfortunately, unlike human health care, animal health care is not free at the point of treatment. If you can’t afford treatment, we can offer emergency first aid to safeguard welfare [1].

Caller: What does that mean?

Your ongoing tension headache tightens its vicious grip as you contemplate the options. You know this puppy probably has parvo virus, almost 100% preventable [2]. If so, the cost of treatment will be very high, as these puppies are high dependency for a long period. They are miserably sick, and some of them will still die, upsetting everyone involved. You also know that no amount of ’emergency first-aid’ will do.

Vet: [still aware of the need to get on with the spleen surgery] We wouldn’t know what that would mean until we had looked at him. I’m concerned that he may have a dangerous virus, and if so he may need a long stay in hospital. You may be eligible for charity help, but if not the treatment may be expensive. If you cannot afford it, you may be able to sign Gucci over into the care of a charity, but when he recovers he would be re-homed. Also, as a last resort, we sometimes have to consider euthanasia in these cases.

Pressing the ‘speaker’ button, you lay your forehead down to rest on the cool white work surface, and, as the caller shouts into the void, you allow yourself to drift off, just for a moment, to another place..

You see, caller, it hurts me when you say I don’t love animals. I was a straight A student in school; I could have done other things, but I wanted to do this because I love animals. I could have done medicine, dentistry or law, and had twice the salary for half the suicide rate. But I love animals. Please don’t misunderstand me, caller- I love my job and I don’t regret doing it. It’s an outstanding privilege to be trusted with the life-or-death care of much loved four-legged family members. And I can tell you love your puppy too. But caller, love isn’t just sentiment, it’s also responsibility and duty. I know you’re frightened and angry, and you’ve got yourself in a situation you can’t handle, but I am not responsible for it. You don’t just have a moral duty, you have a legal one- under the terms of the Animal Welfare Act 2006 you are obliged to make provision for all aspects of your animal’s care [3]. I have an even longer list of obligations- so many I sometimes lie awake and worry about them. But paying for your pet’s medical treatment when you can’t or won’t is not one of them. This job costs me enough already.

Imagine you are pregnant with your first child. A routine ultrasound scan reveals severe brachycephalic deformities (a shortening of the skull) in your unborn daughter. Her skull structure means that her airway will be narrowed and obstructed and her eyes and face will be incorrectly positioned. She will suffer from lifelong breathing difficulties, painful eye and skin conditions, and possible blindness. The common cold could kill her and she may need repeated surgeries on her eyes, face and throat. Any significant exertion will cause her to collapse from oxygen deprivation, and a minor incident could make her eyes prolapse out of their sockets. She will have to stay indoors on warm summer days, and if she wants to have children of her own she may not be able to give birth normally.

This situation would be a tragedy for most parents-to-be, one that they would do almost anything to avoid. Yet people will spend £2000 or more choosing this for their pet dog [4]. The brachycephalic breeds, such as Bulldogs and Pugs, are more desirable and fashionable than ever. Cats are not unaffected either- see your nearest Persian for details- although they arguably suffer less by virtue of their more sedentary lifestyle. So why this different outlook for animals? Although they may have differences in self-awareness of their own appearance, their sentience and capacity to suffer is not in doubt [2].

As a veterinary surgeon, I have an obligation to safeguard animal welfare. This was the oath I took on graduation. I must treat these dogs, and the pain and suffering inflicted on them by human choices, knowing that there are many thousands of healthy but unwanted dogs destroyed each year. It is difficult to support the claim that an anatomically deformed pet is a better companion than one with a healthy conformation. When I have questioned an owner’s decision to buy an unhealthy dog like this, the near-universal response is: “I know… but he’s like my baby… “.

If he or she was their actual baby, they would probably be crowdfunding private health care to pay for what was necessary to give them a shot at an enjoyable life. When it comes to their dog, they enjoy the validation of friends and family (“ooh she’s just so cute…”), and even sometimes that of veterinary professionals, but when it comes to the cost of treating the many problems these animals suffer from, they are strangers to reality. It’s well established that neotenization (preferential selection for juvenile characteristics) of pets has helped them to be successfully domesticated [1], but has it gone too far?

Brachycephalic dogs are not the only ones who suffer because of their deliberately selected anatomy. Dogs such as Dachshunds and Corgis, with cartilage deficits, do not grow legs in proportion to their body, causing spinal disease, pain and arthritis. Shar Peis lack an essential protein which gives their skin elasticity- the wrinkles that people find so endearing result in recurrent skin infections, plus painful eye and ear conditions.

There is an important conceptual difference between breeds like this and those who have ‘normal’ anatomy but inherited disease. The latter can be bred out. Anatomical disease is unavoidable if it is inherent in a preferred “breed standard”. The English Bulldog’s conformation is now so extreme that recent genetic analysis showed its gene pool to be beyond help [3]. But you will still see adverts for bulldog pups citing “healthy type”. The refusal of the Kennel Club to acknowledge this, despite their empty rhetoric about dog welfare, leaves vets with no choice but to do what they can- trying not to offend their clients while also pulling off the impossible feat of fulfilling the oath taken on entering the profession. How do you “do the best for the animals under your care” when a client wants you to help them breed bulldogs?

Many dog lovers have simply never considered the ethical issues involved in their choice of pet. They love their dog deeply and look after him or her responsibly. They simply aren’t aware, and haven’t thought about whether it is morally right to breed and buy dogs who are born with guaranteed negative welfare. Take away the cultural tunnel vision, and surely they could find a dog aesthetically desirable without resorting to cruelty by anatomy? There is no life without suffering, for anyone, but would they get less pleasure from a companion who was at least born with a fighting chance?

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